How I Exercise With Infertility, POTS, and Chronic Pain

It’s been about 18 months since my husband and I first started trying to have a baby. Because of certain test results I got at the time, we were urged to go right to a fertility clinic instead of waiting the recommended one year of trying.

Since that time, I’ve had to change the way I exercise. I stopped running. I quit high-intensity workouts (bye-bye squat jumps). I’ve had to watch my heart rate not just for POTS but also for fertility purposes now.

This change in my workout routine had me a little worried that I’d fall out of shape and lose exercise tolerance. What’s worse, I’ve been dealing with a chronic pain issue since around the same time as our fertility journey started. So on top of changing up my cardio routine, I also couldn’t strength train without pain anymore.

As someone who loves to exercise and depends on it for my mental wellness, it’s been hard to adjust to these changes. Especially when infertility drags on. If you know, you know.

So I thought I’d give an update on what exercise looks like for me right now as someone navigating infertility and IVF, chronic pain, and POTS. It’s a lot to be dealing with, I’ll admit. But I’ve made great progress, and I think I’m handling the changes as best as I can!

Exercising With Infertility

Let’s start with the infertility side of things. My fertility clinic recommended that I stop high-intensity workouts — including running — in favor of more low- to moderate-intensity activities. 

Instead, the providers at the clinic told me to swap running for things like walking, yoga, and pilates. So this is basically what I’ve been doing since October 2024, except I’ll also occasionally bike.

Whatever I’m doing, I’m careful not to exert myself too intensely. I keep a close watch on my heart rate monitor to make sure I’m not in my top heart rate zones. I no longer go for 2-3-mile runs multiple times per week or do HITT workouts in my basement.  

And I’d be lying if I said I don’t miss running. It took me so long — almost a year, if I’m remembering correctly — to work up to that mileage as someone running with POTS. If I tried to run again now, I’m not sure I’d make it more than a block down my street without stopping.

But every time I feel sad about lacing up my sneakers to go for a walk instead of a run, I remind myself why I’m doing this. It’s to help my body successfully conceive so we can start a family. Right now, that’s more important to me than the rush I feel when I run. And I’m confident that some day, I’ll be out there running again — slowly, but with a smile on my face! 

Exercising With POTS

Trying to exercise in a way that isn’t harmful to my fertility but also doesn’t let me lose too much conditioning to manage POTS has been quite the balancing act.

Honestly, I feel like a lot of it is mental. When it takes a long time to get pregnant, it’s hard not to question everything you’re doing and if you’re doing too much of one thing and not enough of something else. For me, I’m uncomfortable doing anything much more than brisk walking to get my heart rate up.

As you know, I used to run for cardio before trying to conceive. I also took Zumba classes, biked, and did HITT workouts to tolerance. All of that kept me in really great cardiovascular shape and helped me manage POTS symptoms.

So when my fertility clinic told me to switch to walking and pilates, I’m not gonna lie, I panicked a little. What if I lost all my conditioning and my POTS symptoms worsened? Would walking be as satisfying as my other go-to forms of exercise? 

But I told myself if I just kept moving as much as possible and didn’t miss too many days in a row of walking, that I would still maintain some level of conditioning. Yes, I still lost a lot. Like I said, if I tried to run now, I wouldn’t get very far.

Now, I try to go for a walk every single day. Some days, they’re shorter, maybe only a mile, but most days I walk for 30-35 minutes. I’ll try to work in one longer walk a week, between 40-45 minutes, but it depends on the day or the week. 

Brisk walking is actually still great physical activity, especially if you add in some hills. This past winter, I started incline walking on the treadmill. My heart rate still got up to the 140s — my cardio zone — doing this!

Now, I wasn’t doing the popular 12-3-30 workout (12% incline, 3 mph, 30 minutes) because I could not just jump into something like that with POTS. I was doing my own version of that — usually around 5-9% incline, at 3 mph, for 10-15 minutes, then flat walking the rest of the time. Each day, I listened to my body (energy level, perceived rate of exertion, heart rate response to exercise) and adjusted the intensity and duration.  

Overall, only walking hasn’t been as awful as I thought it would be. My POTS symptoms have been feeling good again, and I honestly don’t notice a negative difference at all by dropping down to mostly walking. I believe that because I’ve trained my body to walk for 30-40 minutes at a time, things like walking around my house or going shopping don’t feel as hard.

I believe that any upright exercise is good conditioning for POTS management, just based on this experience I’ve had. That might not be the case for everyone with POTS, but I think it is for me, at this moment in my life.   

Exercising With Chronic Pain

Strength training has also looked a little different for me lately. The chronic pain issue I’ve been dealing with since my gallbladder removal surgery has likely turned out to be a case of nasty scar tissue and adhesions. Because they’re located just below my right ribcage in my deep core and oblique muscles, they’ve pulled my ribcage down and pulled my hip bone up, shortening all the muscles in between. My ribs also pop, which can be really painful.

The result was not just a significant amount of pain that took a litany of tests and doctors to diagnose (and delayed our IVF journey), but it also severely limited what type of exercise I could do. Particularly, strength training. I couldn’t lift weights anymore or do a lot of bodyweight strength exercises. Everything besides walking caused pain. 

It was really difficult to see all the muscle I’d put on over the years slowly dissolve, especially in my upper body. But I knew that if I wanted to heal and ever be able to do it again someday, I had to take a break.

So, since late October, I’ve been going to specialized physical therapy. My therapist has been a true lifesaver. They’ve worked to break up those adhesions through manual deep tissue massage and to slowly increase my mobility and strength. It has taken a long time and so much work, but wow, I have made great progress. And my ribcage pain is significantly less than it used to be. In fact, most days, I don’t get any pain at all.

Don’t underestimate the value of a good physical therapist, especially if you live with chronic pain!

Today, my strength training is a lot gentler and focuses mostly on my core and hips. I’ve had to literally start from scratch, beginning with the very basics. (Literally, one of my first exercises was learning how to breathe properly with my diaphragm and belly and not with my chest.) Things like pelvic contractions and tilts, modified dead bugs, bridges, and static Russian twists have become staples in my routine to stabilize my floating ribs, and strengthen my back and core.  

What’s exciting is I can feel my core getting stronger in a way I’ve never felt before. By focusing on my deep core first with exercises as simple as breathing and pelvic tilts, I can now feel my core engaging so much better with other abdominal exercises. I seriously feel like I’ve been doing core wrong my whole life now! 

Stretching and mobility training are also things that I do every day now. They’re just as important to me as my daily walks because they help me with pain management. Trunk rotations, side bends, and cat cows are things you’ll catch me doing while watching TV. I used to strength train hard, but now I stretch hard. 

So, all in all, things are totally different now when it comes to exercise. 

I think the lesson I’ve learned is that exercise should be fluid. It should be ever-changing and adaptable to whatever you need at any point in your life. Doing one form of exercise doesn’t have to be the best and only way to move your body for your entire life. I truly believe that movement at the right dose is medicine. And that dose should fluctuate based on your needs. Maybe some days (or weeks or months) you’ll be capable of handling more, and maybe some days you’ll need to scale back. (Or just rest!)

That’s okay. That’s more than okay. In fact, that’s just right. Doing what you can when you can is all that matters. Let go of any judgment or self-criticism telling you that you should be doing more, and just enjoy moving your body in whatever ways you can. 

What type of exercise works best for you at your current stage of life, and how do you handle adapting your routine? Would anyone like to see my current deep core or mobility routines? Feel free to share your thoughts below! 

Until next time,
Laurie